Paradoxical Normal-Flow Aortic Stenosis Despite Reduced Left Ventricular Ejection Fraction: Insights From the Randomized COMPARE-TAVI 1 Trial.

ABSTRACT:

Background

The hemodynamic profile and remodeling patterns of paradoxical low-flow, low-gradient aortic stenosis are well understood. However, some patients with severe aortic stenosis exhibit eccentric remodeling with enlarged left ventricular cavities, enabling a normal flow, low ejection fraction (NF-LEF) phenotype. We assessed the prevalence, hemodynamic characteristics, and post-transcatheter aortic valve implantation outcomes of NF-LEF.

Methods

In this substudy of the COMPARE-TAVI 1 trial, 979 patients undergoing transfemoral transcatheter aortic valve implantation were stratified by left ventricular ejection fraction (LVEF) (< or ≥50%) and stroke volume index (< or ≥35 mL/m²) into 4 groups: normal flow, normal LVEF, NF-LEF, low flow, normal ejection fractio

SUBMITTER: Ravn EJ 

PROVIDER: S-EPMC12908996 | biostudies-literature | 2026 Jan

REPOSITORIES: biostudies-literature